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BRAIN

Experimental Cerebral Fat Embolism: Embolic Effects of Triolein and Oleic Acid Depicted by MR Imaging and Electron Microscopy

Hak Jin Kima, Jong Hwa Leef, Chang Hun Leeb, Suk Hong Leea, Tae Yong Moona, Byung Mann Choc, Hae Kyu Kimd, Byung Rae Parke and Kee Hyun Changg

a Department of Radiology, Pusan National University College of Medicine, Korea
b Department of Pathology, Pusan National University College of Medicine, Korea
c Department of Preventive Medicine, Pusan National University College of Medicine, Korea
d Department of Anesthesiology, Pusan National University College of Medicine, Korea
e the Interdisciplinary Program in the Department of Biomedical Engineering, Pusan National University College of Medicine, Korea
f Department of Radiology, Ulsan University Hospital, Korea
g Department of Radiology, Seoul National University College of Medicine, Korea

Address reprint requests to Hak Jin Kim, MD, Department of Radiology, Pusan National University Hospital, 10, 1-Ga, Ami-Dong, Seo-Ku, Pusan, 602–739, South Korea

BACKGROUND AND PURPOSE: In fat embolism, free fatty acid is more toxic than neutral fat in terms of tissue damage. We evaluated the hyperacute embolic effects of triolein and oleic acid in cat brains by using MR imaging and electron microscopy.

METHODS: T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging were performed in cat brains after the injection of triolein (group 1, n = 8) or oleic acid (group 2, n = 10) into the internal carotid artery. MR images were quantitatively assessed by comparing the signal intensity ratios of the lesions with their counterparts on T2-weighted images, apparent diffusion coefficient (ADC) maps, and contrast-enhanced T1-weighted images. Electron microscopic findings in group 1 were compared with those in group 2.

RESULTS: Qualitatively, MR images revealed two types of lesions. Type 1 lesions were hyperintense on diffusion-weighted images and hypointense on ADC maps. Type 2 lesions were isointense or mildly hyperintense on diffusion-weighted images and isointense on ADC maps. Quantitatively, the signal intensity ratios of type 1 lesions in group 2 specimens were significantly higher on T2-weighted images (P = .013)/(P = .027) and lower on ADC maps compared with those of group 1. Electron microscopy of type 1 lesions in both groups revealed more prominent widening of the perivascular space and swelling of the neural cells in group 2, in contrast to notable endothelial defects in group 1.

CONCLUSION: MR and electron microscopic data on cerebral fat embolism induced by either triolein or oleic acid revealed characteristics suggestive of both vasogenic and cytotoxic edema in the hyperacute stage. Tissue damage appeared more severe in the oleic acid group than in the triolein group.




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